"..I was unable to walk at all .."
My knee, now containing the large titanium plate and screws holding my knee together, was not able to bend more than 90 degrees and was painful when reaching its maximum range of motion. My arm, still with the plating and cables, was still uncomfortable not being able to rest it adequately on any surface nor bend it beyond 90 degrees as well. The plating, now removed from my shin but still present in my ankle, was causing undue swelling. Owing to the amount of surgery I had experienced to date, I was having daily injections of Deltaparin, which is used primarily to prevent blood clotting in this scenario. My stoma was still needing daily care and I was unable to walk at all without the aid of the gutter frame and even then only 20 feet. Stair climbing was a prohibited act so I was to spend Christmas sleeping on the sofa.
Being handed over to the District Nurses for my care from home, I arrived home at 8pm at night to a tearful reception, not only from myself but my wife waiting at the door. I ask you to picture the situation that has now presented itself, having been married for only 9 months before the collision, my wife was nearly a widdow but, owing to the masses of inner strength unbeknown in my possession, I survived a horrific crash. She was now, having been ad-hoc trained by various departments in the hospital as a helper (the physiotherapists, tissue viability, healthcare assistant, stoma nurse and general nurse), suddenly promoted to my full time carer.
" ..I still wanted to regard my wife as such, not as a nurse .."
Both our knowledge of medical processes, dressings and application, and bodily care had increased 200 percent due to my stay thus far in the hospital environment. Personally though, I drew the line at the Deltaparin injections for my wife to administer to me. I still wanted to regard my wife as such, not as a nurse, so I was very specific in desiring that District Nurses resume the role of injections.
Which brings me to the next NHS failing that I believe exists: the after care. Speaking to a nurse that attended our home one morning, it has now been the 'unwritten' request to hand over as much care of patients in the community to the relatives. This comment was met with much chagrin by ourselves. Quite simply, this short sighted decision to encourage relatives to become more 'actively involved' basically means that there is a clear staffing level issue in the community that cannot be met. Additionally, the extent of my injuries, and the dressings in place to help combat them, confounded some of the experience of the nurses. We felt that a good, active policy, would be to rotate the District Nurses to spend time on the wards with the patients they may eventually care for. That way, they can be kept up to date with modern practices of health care and provide more active solutions in the residential area.
" .. the after care by the NHS is one that needs considerable attention."
In general, from many other patients I have spoken to, ones with traumatic injuries and ones with mental health issues, the after care by the NHS is one that needs considerable attention. To me, it seems that once discharged, the after care is lacking in support; from specialist transportation back to hospital for clinic and appointments, to out-patient physio. The emergency services and Critical Care front end of the NHS is amazing. It is effective, efficient and life saving (I am proof of that). It is only when the long term care begins, from some wards, to the community, is when the issues arise.
I will cover more aspects of this as I talk about when I was discharged.
Back to the tale.
Christmas 2010 was both a physically demanding affair and an emotional rollercoaster rolled into one. Comfy though our sofa was, looking back in hindsight over my desperate need to see homelife over a hospital ward, I don't think I was fully ready to be at home. In order to work into my daily schedule of washing, walking and resting, my wife had to shoulder a great deal of the burden that was once fulfilled by teams of nurses on a shift pattern.
Nights were the worst. Neither of us were able to get much sleep; myself on the sofa downstairs and my wife in our bedroom upstairs. This was primarily because of the ileostomy. It seems to me that those with intestinal problems and have an ileostomy / colostomy to cure them, they can be a blessing in one hand and a nightmare in the other. A blessing as they can give people the freedom to live a semi-normal life, but there's always a concious cloud on the horizon in that your approach to life has to adapt.
The first thoughts on attending any social activity, when having one such colorectal solution, is "Where are the nearest toilets?". Being able to cope with these medical solutions is challenging. With my experience of an ileostomy, it was continually working, throughout the night and day and our adaptions to this resulted in scheduled 2 hourly alarms to wake and ensure it did not need attention.
"Broken sleep leads to broken spirit.."
Broken sleep leads to broken spirit and both my wife and I were constantly tired during this phase. It became a willful necessity to deal with this, when, in a hospital environment, I could reasonably rely on the nurses working a nightshift to assist. If during the night it needed attention, I would use my mobile to send a message up to my wifes phone.
Christmas Day arrived and I opened my parcels on the sofa. Despite the frustrations of my situation, I felt more mentally strengthened by being in a home environment. We ate a Christmas dinner, even though my food intake was not what it once was, and New Year's Day passed in much the same vein. It was then time for me to be re-admitted for my ileostomy reversal.
Little did we know that it would not all go as planned.
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